Makiguchi Takaya, Yokoo Satoshi, Kosugi Kensuke
Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan.
J Craniofac Surg. 2015 Oct;26(7):e582-4. doi: 10.1097/SCS.0000000000002130.
Among the methods to treat temporomandibular joint (TMJ), preauricular, submandibular, retromandibular, and intraoral approaches have been described. These approaches, however, occasionally offer inadequate access, owing to the oblique course of the facial nerve, and access can be limited, especially to the medial and anterior part of the infratemporal fossa. The use of the transparotid approach can offer direct visualization of the facial nerves to prevent severe damage, and a wide work field can be achieved from the medial-anterior part of the infratemporal fossa to subcondylar region by retracting the mobilized facial nerves in either the superior or inferior direction. The 2 patients reported herein illustrate the addition of a transparotid approach to the standard procedures for the removal of an osteochondroma and condylectomy with displaced bone fragment for ankyloses of TMJ from the infratemporal fossa.
在治疗颞下颌关节（TMJ）的方法中，已描述了耳前、下颌下、下颌后和口内入路。然而，由于面神经走行倾斜，这些入路偶尔提供的手术视野不足，并且手术视野可能受限，尤其是对于颞下窝的内侧和前部。使用经腮腺入路可以直接观察面神经以防止严重损伤，通过向上或向下牵拉游离的面神经，可从颞下窝的内侧前部到髁突下区域获得广阔的手术视野。本文报道的2例患者说明了在标准手术中增加经腮腺入路，用于从颞下窝切除骨软骨瘤以及为颞下颌关节强直伴移位骨碎片行髁突切除术。
